Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) (previously known as dysmorphophobia is sometimes referred to as body dysmorphia or dysmorphic syndrome) is a (psychological) somatoform disorder in which the affected person is excessively concerned about and preoccupied by a perceived defect in his or her physical features (body image).

The sufferer may complain of several specific features or a single feature, or a vague feature or general appearance, causing psychological distress that impairs occupational and/or social functioning, sometimes to the point of severe depression and anxiety, development of other anxiety disorders, social withdrawal or complete social isolation, and more. It is estimated that 1–2% of the world’s population meet all the diagnostic criteria for BDD (Psychological Medicine, vol. 36, p. 877).

The exact cause(s) of BDD differ(s) from person to person. However, most clinicians believe it could be a combination of biological,psychological, and environmental factors from their past or present. Abuse and neglect can also be contributing factors.

Onset of symptoms generally occurs in adolescence or early adulthood, where most personal criticism of one’s own appearance usually begins, although cases of BDD onset in children and older adults are not unknown. BDD is often misunderstood to affect mostly women, but research shows that it affects men and women equally.

The disorder is linked to significantly diminished quality of life and can be co-morbid with major depressive disorder and social phobia, also known as chronic social anxiety. With a completed-suicide rate more than double that of major depression (three to four times that of manic depression) and a suicidal ideation rate of around 80%, extreme cases of BDD linked with dissociation can be considered a risk factor for suicide; however, many cases of BDD are treated with medication and counseling.

A person with the disorder may be treated with psychotherapy, medication, or both. Research has shown cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitors(SSRIs) to be effective in treating BDD.

BDD is a chronic illness, and symptoms are likely to persist, or worsen, if left untreated.